2012 Volume 34 Issue 1 Pages 38-43
Background. Recent case reports regarding mucoid impaction of bronchi (MIB) and allergic bronchopulmonary mycosis (ABPM) caused by Schizophyllum commune (S. commune), a basidiomycetous fungus, have indicated a need for more successful therapies. However, the effective treatment has not yet been established. Case. A 68-year-old woman was referred to our hospital because of persistent cough and wheezing lasting at least 4 years. Chest X-rays showed an infiltrative shadow in the right lower lung field. Chest CT scans revealed partial collapse in the right B^8 bronchus, which suggested a mucous plug, and an infiltrative shadow in the right S^8. Laboratory tests showed a high serum IgE level and mild eosinophilia. The bronchoscopic findings in the right B^8 showed thick yellow mucous plugs, which consisted histologically of eosinophil accumulation with hyphae while the culture revealed S. commune. We diagnosed this case as MIB and ABPM caused by S. commune. A transbronchial removal of this mucous plug relieved her symptoms and diminished abnormal shadows in the chest X-ray. Following this treatment, no recurrence has been observed for 18 months. Conclusion. We experienced a case of ABPM/MIB caused by S. commune whose clinical course was improved by transbronchial removal of a mucous plug.